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  • Patient delivered partner therapy for chlamydia infection is used by some general practitioners, but more support is needed to increase uptake: findings from a mixed-methods study

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Health services research
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Patient delivered partner therapy for chlamydia infection is used by some general practitioners, but more support is needed to increase uptake: findings from a mixed-methods study
  1. Jane L Goller1,
  2. Jacqueline Coombe1,
  3. Helen Bittleston1,
  4. Christopher Bourne2,3,
  5. Deborah Bateson4,5,
  6. Alaina Vaisey1,
  7. Jane Tomnay6,
  8. Heather O'Donnell7,
  9. Cameryn Garret8,
  10. Claudia S Estcourt9,
  11. Meredith Temple-Smith10,
  12. Jane S Hocking1
  1. 1 Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
  2. 2 Sydney Sexual Health Centre, Sydney, New South Wales, Australia
  3. 3 Kirby Institute, Kensington, New South Wales, Australia
  4. 4 Family Planning New South Wales, Ashfield, New South Wales, Australia
  5. 5 Discipline of Obstetrics, Gyanecology and Neonatology, Faculty of Medicine and Science, University of Sydney SDN, Sydney, New South Wales, Australia
  6. 6 Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
  7. 7 Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
  8. 8 Family Planning Victoria, Box Hill, Victoria, Australia
  9. 9 Glasgow Caledonian University School of Health and Life Sciences, Glasgow, UK
  10. 10 School of Health & Life Science, Glasgow Caledonian University, Glasgow, UK
  1. Correspondence to Jane L Goller, Centre for Epidemiology and Biostatistics, The University of Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; jane.goller{at}unimelb.edu.au

Abstract

Objectives Patient-delivered partner therapy (PDPT) describes the giving of a prescription or antibiotics by an index case with chlamydia to their sexual partners. PDPT has been associated with higher numbers of partners receiving treatment. In Australia, general practitioners (GPs) previously expressed negative views about PDPT. Health authority guidance for PDPT has since been provided in some areas. We investigated recent use and perceptions of PDPT for chlamydia among GPs in Australia.

Methods In 2019, we conducted an online survey comprising multiple-choice and open-ended questions to investigate GPs’ chlamydia management practices, including PDPT. Logistic regression identified factors associated with ever offering PDPT. A directed content analysis of free-text data explored GPs’ perceptions towards PDPT.

Results The survey received responses from 323 GPs; 85.8% (n=277) answered PDPT-focused questions, providing 628 free-text comments. Over half (53.4%) reported never offering PDPT, while 36.5% sometimes and 10.1% often offered PDPT. GPs more likely to offer PDPT were aged ≥55 years (adjusted OR (AOR) 2.9, 95% CI 1.4 to 5.8), worked in non-metropolitan areas (AOR 2.5, 95% CI 1.5 to 4.4) and jurisdictions with health authority PDPT guidance (AOR 2.3, 95% CI 1.4 to 3.9). Qualitative data demonstrated that many GPs recognised PDPT’s potential to treat harder to engage partners but expressed hesitancy to offer PDPT because they considered partners attending for care as best practice. GPs emphasised a case-by-case approach that considered patient and partner circumstances to determine PDPT suitability. To alleviate medicolegal concerns, many GPs indicated a need for professional and health authority guidance that PDPT is permissible. They also desired practical resources to support its use.

Conclusion GPs appear to accept the place of PDPT as targeted to those who may otherwise not access testing or treatment. Availability of health authority guidance appears to have supported some GPs to incorporate PDPT into their practice.

  • chlamydia infections
  • contact tracing
  • sexual health
  • primary health care

https://doi.org/10.1136/sextrans-2020-054933

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    Footnotes

    • Handling editor Jo Gibbs

    • Contributors JLG, JC and JSH conceived the subject matter; JLG and JC coordinated the data collection; JLG, JC and HB managed the data and JLG conducted the analysis with support from JC and HB. JLG undertook the main contribution to the paper. JC, HB, CB, DB, AV, JT, HOD, CG, CSE, MT-S and JSH all contributed to the interpretation of the findings and writing the paper with oversight from JSH.

    • Funding These data are being analysed as part of the Management of Chlamydia Cases in Australia study funded by the National Health and Medical Research Council (APP1150014).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.